Provider Demographics
NPI:1548519598
Name:TOUSSAINT, CHELSEA A (DMD)
Entity type:Individual
Prefix:DR
First Name:CHELSEA
Middle Name:A
Last Name:TOUSSAINT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 NEWTON ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-1536
Mailing Address - Country:US
Mailing Address - Phone:207-409-9243
Mailing Address - Fax:
Practice Address - Street 1:1036 BRIGHTON AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:ME
Practice Address - Zip Code:04102-1059
Practice Address - Country:US
Practice Address - Phone:207-517-6276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-06
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERDH3614124Q00000X
MEDEN45751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
No124Q00000XDental ProvidersDental Hygienist